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Yayınlar
- MakaleAçık Erişim2026Nöroanatomi Eğitimini Geliştirmek İçin Difüzyon MRI Analizi ile Birlikte Traktografi Yazılımının Kullanılması: Bir Nöroanatomi Eğitim Çalışması
Palancı, Özgür; Aygün, Tayfun; Keskin, Arif; Salbacak, Ahmet; Kazancı, Necip Furkan
Amaç: Bu çalışma, geleneksel nöroanatomi eğitimine ek olarak DSI Studio yazılımı kullanılarak yapılan segmentasyon ve traktografi eğitiminin tıp öğrencilerinin akademik başarısı üzerindeki etkisini değerlendirmeyi amaçlamıştır. Gereç ve Yöntemler: Çalışma, gönüllü ikinci sınıf tıp öğrencileriyle yapılmıştır. Traktografi eğitimine katılan öğrenciler çalışma grubunu (n=32), katılmayanlar ise kontrol grubunu (n=40) oluşturmuştur. Her iki gruba da eğitim öncesi ve sonrası 23 maddelik çoktan seçmeli bir bilgi testi uygulanmıştır. Eğitim içeriği nöronal yapılar, DTI/DSI'nin temel prensipleri, Brodmann alanları, beyaz madde organizasyonunun görselleştirilmesi ve üç boyutlu traktografi uygulamalarını içermiştir. Veriler SPSS 27.0 kullanılarak analiz edilmiş ve istatistiksel anlamlılık düzeyi p<0,05 olarak belirlenmiştir. Bulgular: Her iki grupta da son test puanları ön test puanlarından anlamlı derecede yüksek bulunmuştur (p<0,001). Bununla birlikte, çalışma grubu kontrol grubuna kıyasla anlamlı derecede daha yüksek son test puanları elde etmiştir (p=0,044). Çalışma grubunda ön test sonrası fark (öğrenme kazanımı) da daha büyüktü (p=0,013). Gruplar arasındaki öğrenme kazanımı için etki büyüklüğü orta düzeydeydi. Sonuç: DSI Studio ile gerçekleştirilen segmentasyon ve traktografi uygulamaları, nöroanatomik yapıların üç boyutlu incelenmesini ve değerlendirmesini sağlayarak nöroanatomi eğitiminde akademik performansı artırır. Bu tür yazılımların tıp eğitimine entegrasyonu, özellikle karmaşık anatomik yapıları içeren konularda öğrenme sürecini kolaylaştırabilir.
- MakaleAçık Erişim2026Ergenlerde Akıllı Telefon Bağımlılığı İle Sosyal Kaygı Arasındaki İlişki: Çoklu Aracılık Modeli
Alsaç, Selda Yüzer; Türkmen, Osman Oğulcan; Tuncay, Birgül
Bu çalışma, ergenlerde akıllı telefon bağımlılığı ile sosyal kaygının alt boyutları arasındaki ilişkiyi, bir çoklu aracılık modelini test ederek incelemiştir. Tanımlayıcı-kesitsel desende yürütülen araştırmanın verileri, 306 lise öğrencisinden toplanmıştır. Bulgular, akıllı telefon bağımlılığı ile sosyal kaygının kilit boyutları arasında anlamlı ilişkiler olduğunu göstermiştir. Çoklu aracılık analizi sonucunda, sosyal kaygının bilişsel temelini oluşturan olumsuz değerlendirilme korkusu ile akıllı telefon bağımlılığı arasındaki ilişkide, yeni sosyal durumlardaki korku ve huzursuzluk duyma alt boyutunun tam aracı rol üstlendiği belirlenmiştir. Buna karşın, genel sosyal durumlardaki korku ve huzursuzluk duyma alt boyutunun bu ilişkide aracı bir rolü olmadığı saptanmıştır. Cinsiyetin bağımlılık düzeylerinde anlamlı bir faktör olmadığı görülürken, kişisel telefon sahipliği ve kullanım süresine göre bağımlılık düzeyleri farklılaşmaktadır. Bu sonuçlar, olumsuz değerlendirme korkusunun bağımlılığa giden yolu özellikle yeni sosyal durumlara karşı duyulan kaygı üzerinden tetiklediğini gösteren aracılık modelini desteklemektedir. Sonuç olarak bu çalışma, sosyal kaygıyı ele alan psikoeğitim programlarının, bu popülasyondaki sorunlu akıllı telefon kullanımını azaltmak için etkili bir strateji olabileceğini vurgulamaktadır.
- MakaleAçık Erişim2026Quality of Life in Patients with Hematological Malignancy Receiving High-Dose Chemotherapy : A Descriptive Study
Çakmak, Seher; Nural, Nesrin
Introduction: Hematological malignancies reduce quality of life due to aggressive treatments and related complications. Aim: The aim of this study was to evaluate the quality of life of hematologic cancer patients receiving high-dose chemotherapy. Methods: This descriptive cross-sectional study was conducted with 158 patients selected by simple random sampling method who were treated in the hematology clinic of a university hospital. Data were collected using a personal information form and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30. Results: 51.3% of the patients were aged 18 - 50 years, 52.5% were female, and 67.1% had a diagnosis of leukemia. The mean scores of the quality of life scale were 74.47 ± 19.92 for the functional scale, 71.31 ± 19.31 for the symptom scale, and 39.82 ± 26.31 for the global quality of life. These findings indicate that patients had relatively good functional status, high symptom burden, and low overall quality of life. Among the functional subscales, the highest mean score was observed in cognitive functioning (85.7 ± 18.8), while the lowest was in social functioning (68.9 ± 32.5). Patients diagnosed with lymphoma had significantly lower functional scale scores (p = 0.002), whereas patients with leukemia and those with a history of chemotherapy had significantly higher symptom scale scores (p = 0.017 and p = 0.026, respectively). Conclusion: In conclusion, it was determined that patients had a low quality of life, particularly in the areas of physical and social functioning, and a high symptom burden. Higher symptoms in patients with leukemia and prior chemotherapy underscore the need for symptom control and functional assessment.
- MakaleAçık Erişim2026Evaluation of the Correlation Between Quality of Life and E-Healthy Diet Literacy and Food Choices in Young Adults
Koçyıgıt, Emıne; Demirel, Yağmur; Koçak, Tevfık
Aim: This study aimed to assess the correlation between quality of life, dietary literacy, and food choices among young adults. Material and Method: This cross-sectional research involved 522 young individuals aged 19 to 34. Face-to-face interviews and a questionnaire were used for collecting data. A sociodemographic characteristics form, the World Health Organization Quality of Life (QoL) Scale, the Food Choice Questionnaire (FCQ), and the e-Healthy Diet Literacy (e-HDL) Questionnaire were used to obtain data. Results: Of the study population, 50.20% were male and 49.80% were female. Participants had a mean age of 23.66 ± 3.40 years and a BMI of 23.08 ± 3.61 kg/m2. Males had a higher FCQ sensory appeal subdimension score than females, but there were no gender differences in total e-HDL and QoL scores. Overall e-HDL score, assessing, applying, and finding subscores correlated positively with FCQ weight management, ethical concerns, health, and natural content characteristics. The FCQ subdimension scores, overall QoL, and total e-HDL did not correlate significantly. Conclusion: QoL and e-HDL scores were comparable across genders; however, in terms of food choices, females emphasized health and ethical considerations, while males prioritized sensory attributes.
- MakaleAçık Erişim2026Bicuspid Aortic Valve in Adult Patients: Accompanying Cardiovascular Pathology and Variations
Akturk, Yeliz; Durmus, Irfan; Kavak, Rasime Pelin; Ozdemir, Meltem
Introduction: This study aimed to investigate the prevalence of aortic valve calcification, aortic dilatation, and coronary artery disease (CAD) in patients with bicuspid aortic valve (BAV) identified incidentally through coronary computed tomography angiography (CCTA) and to compare epicardial adipose tissue (EAT) thickness between BAV and tricuspid aortic valve (TAV) patients. Materials and Methods: Thirty-five BAV patients aged 42-67 and 75 TAV patients aged 31-66 were included in the study. Aortic diameters were measured at the sinus of Valsalva, sinotubular junction, and ascending and descending aorta. Agatston calcium scores and CAD-Reporting and Data System were used to assess coronary artery calcification and atherosclerosis severity. EAT thickness was measured volumetrically, and its relationship with clinical and imaging parameters was evaluated. Results: In patients with BAV, the aortic diameters at the Valsalva sinus, sinotubular junction, and ascending aorta were larger compared to patients with TAV. The difference was statistically significant (P < 0.001). Aortic valve calcification was present in 45.7% of BAV patients, with an average Agatston score of 349.06 +/- 413.22, while no calcification was detected in TAV patients. Although no significant difference in EAT thickness or CAD prevalence was observed between BAV and TAV groups, EAT thickness was positively correlated with aortic dilatation, coronary artery calcification, and aortic valve calcification. Conclusions: BAV patients exhibit distinct vascular and valvular characteristics, with aortic dilatation and aortic valve calcification being prominent. EAT may serve as a marker for these complications. Further prospective studies are needed to elucidate the pathophysiology of BAV and optimize early intervention strategies.
- MakaleAçık Erişim2026INVESTIGATION OF THE EFFECT OF INSTRUMENT-ASSISTED SOFT TISSUE MOBILIZATION IN INDIVIDUALS WITH LUMBAR DISC HERNIATION: A RANDOMIZED CLINICAL TRIAL
Tas, Muhammed Usame; Usgu, Gunseli
Purpose: This research evaluated the effects of the instrument-assisted soft tissue mobilization (IASTM) technique in individuals with lumbar disc herniation (LDH). Methods: Forty LDH patients were randomly assigned to a control group or an IASTM group (20 patients in each group). The IASTM group underwent a treatment protocol consisting of two IASTM sessions per week in addition to classic physiotherapy methods (hotpack, transcutaneous electrical nerve stimulation, ultrasound and exercise) over a four week period. The treatment specifically targeted the paraspinal muscles, gluteus maximus, gluteus medius and hamstring muscles. All participants were assessed before treatment, immediately after treatment and two months post-treatment using various measures, including pain intensity visual analog scale, straight leg raise (SLR) test, slump test (measuring knee extension from 90 degrees flexion), 6-minute walking test (6-MWT), range of motion (ROM) and the Short Form-36 (SF-36) questionnaire. Results: Both groups experienced a significant decrease in pain immediately after treatment (p=0.002). However, although both groups showed improvements in post-treatment SLR, slump test, 6-MWT, ROM, and SF-36 scores, no significant correlations were found (p=0.208). However, the IASTM group experienced greaterclinical improvement across all parameters. Conclusion: The findings suggest that incorporating IASTM techniques into physiotherapy programs for individuals with LDH can enhance rehabilitation outcomes.
- MakaleAçık Erişim2026Use of Piezoelectric Devices in Closed Structural Rhinoplasty
Kaderi, Sina; Ekinci, Can
Background Closed rhinoplasty techniques are gaining popularity once again as more and more patients demand them. The use of piezoelectric devices (PEDs) is also another popular practice in rhinoplasty surgeries recently to reduce postoperative edema and bruising. Objectives The aim of this study was to propose a new technique in which all osteotomies in closed rhinoplasty surgeries can be performed using PEDs. Methods A comparison was made between 274 patients who underwent closed piezo (CloPi) rhinoplasty and 120 patients who underwent closed rhinoplasty using conventional osteotomy. In the CloPi technique, all osteotomies, including lateral and transverse osteotomies, were performed with PEDs using straight and 90 degrees curved tips. Preoperative and postoperative results obtained with the Rhinoplasty Outcome Evaluation (ROE) questionnaire were compared to evaluate aesthetic and functional results. Results In the CloPi group, the mean age was 30.8 years (range, 18-60 years) and the mean follow-up period was 19.6 months, whereas in the control group, the mean age was 33.5 years (range, 18-61 years) and the mean follow-up period was 29.3 months. Significantly better results were obtained in the ROE questionnaire compared with preoperative values in both groups (P < .001). When comparing the postoperative-preoperative change in ROE scores between the 2 groups, the improvement observed in the CloPi cohort was significantly greater for all items (P < .001), except for Question 2-assessing the ability to breathe-where no significant difference was detected (P = .231). Conclusions CloPi rhinoplasty is an easy and reliable technique in which all osteotomies can be performed with PEDs. Successful surgical results can be achieved with wide surgical dissection.Level of Evidence 3 (Therapeutic)
- MakaleYalnız künye2026Women's breast cancer prevention behaviors and cancer fears: the sample of post-earthquake
Aydin, Aydanur
In the event of a natural disaster, women who assume multiple roles within the family unit tend to postpone their health concerns and delay medical appointments. The present study aims to examine the relationship between the level of fear of breast cancer and the implementation of breast cancer preventive behaviours among women following an earthquake. The sample consists of 2,671 women aged 20 and over who participated voluntarily. The data were collected using two instruments: the Breast Cancer Fear Scale and the Women's Breast Cancer Prevention Behaviors Form. Following a comprehensive review of the extant literature, it was determined that women affected by earthquakes exhibited elevated levels of fear of breast cancer. A substantial decline was observed in the utilization of preventive measures necessitating institutional access, including mammography. The findings of this study indicate that education, occupation, and family history of breast cancer have a significant impact on women's post-earthquake fear levels in implementing preventive behaviours. However, given the cross-sectional design and the absence of pre-disaster baseline data, these findings reflect post-earthquake associations rather than temporal or causal trends. Natural disasters can result in the deterioration of health perceptions, exacerbated by heightened stress and health concerns. Consequently, there is an urgent need for innovative approaches to ensure the maintenance of health check-ups and continuous access to preventive care in the aftermath of large-scale natural disasters.
- MakaleAçık Erişim2026Examination of Health-Seeking Behavior in Individuals with Chronic Diseases
Cosar, Dilan Aktepe; Demirag, Hatice; Cin, Aynur
Background: Chronic illnesses are long-term, noncommunicable diseases that significantly affect daily life. In addition to physical symptoms, they can reduce quality of life by causing psychological effects such as anxiety and depression. Patients often seek health information to better manage their condition. Methods: This study aimed to examine the level of health information-seeking behavior among individuals with chronic diseases and the factors influencing this behavior. The sample group for this descriptive study consisted of 306 individuals with chronic illnesses who visited X Hospital in northeastern T & uuml;rkiye between April 1, 2024, and February 1, 2025. All individuals completed a questionnaire consisting of the Patient Information Form and the Health Seeking Behavior Scale. Results: The sociodemographic characteristics of patients with chronic diseases, such as education level, marital status, and chronic disease duration, significantly affected the health-seeking behavior scores. According to the research findings, the highest mean score was determined as 12.30 +/- 2.62 in the occupational health-seeking subdimension, whereas the lowest mean score was determined as 8.78 +/- 3.83 (min-max: 3-15) in the traditional health-seeking subdimension. The total mean score of the Health Seeking Behavior Scale was 32.2 7 +/- 7.73. Conclusions: Individuals with chronic illnesses tend to prefer professional health care services when seeking health-related behaviors. Health-seeking behaviors were higher among high school graduates, single individuals, and those without chronic illnesses.
- MakaleAçık Erişim2026Effect of Digital Health Literacy and E-health Literacy on Quality of Life: A systematical Review
Köse, Asli
Employing the systematic review methodology, this study aims to address how digital health literacy and e-health literacy influence people's quality of life. This systematic review includes studies that examined the effect of e-health literacy and digital health literacy on quality of life. The results of 12 research papers meeting the standards established within the parameters of this study were divided into two groups: ehealth literacy and digital health literacy. The effect of e-health literacy on quality of life was assessed in five of the thirteen studies, whereas that of digital health literacy on quality of life was assessed in eight of them. The study sample consisted of people with cancer, people with long-term conditions like asthma, people who were following their postoperative treatment regimens, people affected by the COVID-19 epidemic, the elderly, women, children, and students. Only one study reported that e-health literacy had a negative influence on quality of life, whereas 11 studies emphasized that digital health and e-health literacy had a positive influence. Policies are required to facilitate the use and access to digital health technology by various societal groups, including patients, the elderly, women with unequal social status, children, and learners.
- MakaleYalnız künye2026Examining the relationship between ethical values and self-discipline
Gül, Ismail; Koç, Ozcan; Arslan, Adem
Healthcare management students undergo an educational process aimed at acquiring various knowledge and skills to achieve professional competence. Self-discipline and ethical values play a crucial role in both academic success and professional development during this process. Self-discipline contributes to students' timely and effective completion of their duties, while ethical values enhance individuals' ability to distin-guish right from wrong and to act in accordance with social norms. This study examined the relationship between the ethical value perceptions and self-discipline levels of G & uuml;m & uuml;shane University Health Management students. Quantitative methods were used in the study and data were collected via a survey. The data obtained were analyzed using t-tests, ANOVA, and correlation analysis. The analysis results revealed a significant relationship between students' ethical value perceptions and self-discipline levels. These findings demonstrate that ethical values and self-discipline are not inde-pendent concepts; rather, they are interconnected, complementary, and reinforcing. The research is expected to contribute to the development of educational programs in the field of healthcare management and to guide practices aimed at increasing students' ethical and self-discipline levels.
- MakaleAçık Erişim2026The mediating role of physical self-perception and the moderating effect of gender in the association between physical activity and psychological well-being among young recreational participants
Ekizoglu, Ozlem; Tetik, Sibel; Zambak, Omer; Temur, Canan Sayin; Can, Yusuf; Isik, Utku; Koc, Mustafa Can
Background/objective Psychological well-being disorders are increasingly prevalent among young people. While physical activity is known to benefit psychological well-being, the mechanisms-particularly the role of physical self-perception and gender in recreational context remain underexplored. Grounded in the Conservation of Resources (COR) Theory, this study investigates the mediating role of physical self-perception in the relationship between recreational physical activity and psychological well-being and examines whether gender moderates this mediation among youth aged 15-24.Methods A descriptive-relational survey design was employed. The sample comprised 468 young adults (58.5% male, 41.5% female; M_age = 20.08) who regularly participated in recreational physical activities. Data were collected using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Physical Self-Perception Profile (PSPP), and the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Mediation and moderation analyses were conducted using PROCESS macro-Models 4 and 7.Results The direct effect of physical activity on psychological well-being was not significant. However, physical self-perception fully mediated the relationship between physical activity and psychological well-being (indirect effect: beta = 0.219, 95% CI [0.151, 0.290]). Among the sub-dimensions of physical self-perception, body attractiveness had the strongest mediating effect. Moderation analysis revealed that gender did not significantly moderate the mediation pathways (a path: p = 0.156; b path: p = 0.954). The mediation mechanism operated with similar strength in both males and females.Conclusion Recreational physical activity improves psychological well-being entirely through the enhancement of physical self-perception, supporting the COR theory that physical activity acts as a resource investment. This mechanism is universal across genders in recreational settings. Interventions aiming to improve youth psychological well-being should not only promote physical activity but specifically focus on fostering positive physical self-perception and body image in inclusive, non-judgmental environments.
- MakaleAçık Erişim2026The COPD-augmented R2CHA2DS2-VA score: development and internal assessment for predicting one-year outcomes after transcatheter aortic valve implantation
Boyaci, Faruk; Sahin, Mustafa Kursat; Akcay, Murat; Yanik, Ahmet; Yenercag, Mustafa; Seker, Onur Osman; Ucar, Melisa; Kokcu, Halil Ibrahim; Ozturk, Berkant; Kaya, Enes
Background Existing CHA(2)DS(2)-VASc-based scores incompletely capture the prognostic impact of chronic obstructive pulmonary disease (COPD) and of graded renal dysfunction in patients undergoing transcatheter aortic valve implantation (TAVI). We acknowledge that the score's development in a high-risk, high-comorbidity cohort may produce optimistic performance estimates that require attenuation through external validation. We aimed to develop a novel COPD-augmented R(2)CHA(2)DS(2)-VA (COPD-R(2)CHA(2)DS(2)-VA) score that systematically integrates quantitative renal function and COPD, and to internally assess its discriminative performance for one-year all-cause mortality and major adverse cardiovascular events (MACE). Methods In this single-center, retrospective cohort study, 622 consecutive patients undergoing TAVI for severe aortic stenosis (2018-2024) were analyzed. The COPD-R(2)CHA(2)DS(2)-VA score was constructed as a prespecified clinical tool by augmenting the R(2)CHA(2)DS(2)-VA framework with COPD (1 point) and refining renal dysfunction into two graded estimated glomerular filtration rate strata (eGFR 30-59 mL/min/1.73 m & sup2;: 1 point; eGFR < 30: 2 points). Discriminative performance was evaluated using receiver operating characteristic curve analysis with bootstrap internal validation (2,000 resamples) and compared with established CHA(2)DS(2)-VASc-based scores. Multivariable logistic regression assessed the independent prognostic value of the score treated as a continuous variable. Results The COPD-R(2)CHA(2)DS(2)-VA score demonstrated encouraging discriminative ability for one-year all-cause mortality (apparent area under the curve [AUC] 0.946, 95% CI 0.926-0.971). As a prespecified tool with fixed component weights, bootstrap internal validation confirmed negligible optimism (mean optimism - 0.00014), with bias-corrected AUC identical to the apparent value. The addition of COPD significantly improved mortality discrimination over the R(2)CHA(2)DS(2)-VA score (Delta AUC + 0.033, p = 0.0001). For one-year MACE, the apparent AUC was 0.806 (95% CI 0.765-0.852); the addition of COPD did not significantly enhance MACE discrimination (Delta AUC + 0.001, p = 0.853). In multivariable analysis, each one-point increase in the COPD-R(2)CHA(2)DS(2)-VA score was independently associated with 3.52-fold higher odds of one-year mortality (95% CI 2.45-5.06, p < 0.001) and 2.02-fold higher odds of MACE (95% CI 1.67-2.46, p < 0.001). The bias-corrected AUC of the full multivariable model was 0.973 (95% CI 0.962-0.984) for mortality and 0.795 (95% CI 0.752-0.841) for MACE. Conclusions The COPD-R(2)CHA(2)DS(2)-VA score demonstrated encouraging discriminative ability for one-year all-cause mortality after TAVI in this single-center development cohort (apparent AUC 0.946). However, this high discriminative performance is likely influenced by the elevated comorbidity burden in our cohort and the single-center design, and should be interpreted as an upper-bound estimate. The addition of COPD provides a statistically significant but clinically modest incremental improvement for mortality (Delta AUC + 0.033, p = 0.0001), with no significant enhancement for MACE (Delta AUC + 0.001, p = 0.853). These findings are preliminary and hypothesis-generating; urgent external validation in diverse, prospective cohorts is essential before any clinical application can be considered. At present, this score should be regarded as a development-phase, hypothesis-generating tool that complements rather than replaces guideline-recommended instruments such as STS-PROM and EuroSCORE II. The score's clinical utility remains unproven.
- Derleme MakaleAçık Erişim2026Nanoplastic Translocation Across Biological Barriers (Blood-Brain, Placental, Intestinal): Transport Mechanisms, Tissue-Specific Vulnerabilities, and a Corona-Driven Barrier Selectivity Framework
Berber, Ahmet Ali; Yildiz, Esra; Berber, Nurcan; Kurnaz, Muammer; Kenanoglu, Nihan Akinci
Nanoplastics (NPs; <= 1 & micro;m) have been detected in human placenta, blood, lung, atherosclerotic plaque, testis, semen, olfactory bulb, and brain, shifting the field from environmental description toward mechanistic interrogation of barrier crossing. This review synthesises current evidence on NP translocation across the intestinal epithelium, the blood-brain barrier (BBB) and the placental syncytiotrophoblast. We distinguish four evidence categories throughout the review: detection, association, mechanism, and causality. We also apply model-system labels (in silico, in vitro, ex vivo, animal, and human) to every mechanistic claim, so that the strength of each statement can be read off directly. Most current studies use pristine polystyrene nanoplastics at concentrations 3-6 orders of magnitude above plausible human exposure, so the mechanistic conclusions below are hypothesis-generating for human disease rather than definitive. We propose a working conceptual framework-corona-driven barrier selectivity (CDBS)-in which the particle-corona-surface complex, rather than the bare polymer, is hypothesised to dictate which receptor and transport machinery (TfR1, LRP1, FcRn, P-gp/BCRP, caveolae) each barrier engages. CDBS is offered as a hypothesis-stage organising tool requiring experimental validation, not as an established mechanism. We outline reported transport modes, including clathrin- and caveolin-mediated endocytosis, paracellular leakage via ROS-induced tight-junction disassembly, receptor-mediated transcytosis, and the candidate olfactory route. We emphasise that pristine polystyrene-bead doses commonly exceed plausible human exposure by 3-6 orders of magnitude, that detection methods underestimate sub-micrometre particles, and that causal links between NPs and human disease remain hypothesis-generating. A research agenda built on weathered reference materials, microphysiological systems, and integrative human biomarker science is proposed.
- MakaleYalnız künye2026The Predictive Role of Fetal Growth for Placental Invasion Anomalies in Placenta Previa
Koca, Evrim; Dincgez, Burcu; Ozgen, Gulten; Simsek, Deniz
Objective To evaluate the predictive role of fetal percentile for placental invasion anomalies in placenta previa cases. Study Design: Retrospective studyPlace & Duration of the Study: Training and Research Hospital, January 2018 and December 2023 Methodology A total of 298 placenta previa cases was divided into two groups: PAS (placenta accreta spectrum)-positive placenta previa (n=98) and PAS-negative placenta previa (n=200). Then PAS-positive placenta previa cases were divided into two subgroups: placenta increta-accreta (n=59) and placenta percreta (n=39). Sociodemographic findings, obstetric features, fetal percentile measurements between 22 and 28 gestational weeks and perioperative characteristics of patients were recorded and compared between groups. Results Fetal percentile was significantly lower in PAS-positive placenta previa cases as compared to PAS-negative placenta previa cases (p<0.001). Moreover, fetal percentile <= 52.5 discriminated PAS-positive placenta previa cases from PAS-negative placenta previa cases with 75.51% sensitivity and 51.5% specificity (p<0.001, AUC=0.654). In multivariate analysis, a fetal percentile of 52.5 and below increased the risk of PAS by approximately 4 times (Hosmer-Lemeshow p=0.101, model p<0.001). No significant difference was detected between placenta percreta and placenta accreta-increta groups in terms of fetal percentile (p=0.224). Conclusion Fetal percentiles calculated between 22 and 28 gestational weeks could discriminate PAS-positive placenta previa cases from PAS-negative placenta previa cases, although it had no role in discriminating placenta percreta from accreta and increta cases. Therefore, the evaluation of fetal percentile in placenta previa cases can be considered as a supportive finding in the prediction of invasion anomaly although it does not determine the depth of invasion.
- Derleme MakaleAçık Erişim2026Microplastic Contamination in Amphibians and Reptiles: An Ecotoxicological Synthesis of Exposure, Mechanisms, and Risk Implications
Berber, Ahmet Ali; Akbulut, Cansu; Demir, Sefika Nur; Kurnaz, Muammer
Microplastic (MP) contamination has become a defining feature of twenty-first century environmental change, yet the toxicological and ecological consequences for amphibians and reptiles-two vertebrate classes already facing severe extinction pressures-remain fragmented across taxa, regions, and methodological traditions. Here, we synthesize field and experimental evidence from five continents to provide a taxonomically balanced, mechanistically grounded, and geographically explicit assessment of MP exposure, bioaccumulation, and toxicity in herpetofauna, drawing on a structured literature search in Web of Science, Scopus, and PubMed (January 2015-March 2026). Field detection rates of MPs in amphibian larvae range from 26% in conservatively screened Central European populations to 73-80% in anuran tadpoles from high-anthropogenic-pressure Anatolian catchments, with fibrous polyethylene terephthalate (PET), polyethylene (PE), and polypropylene (PP) particles dominating the detected burden. Mechanistic evidence converges on oxidative stress cascades, hypothalamic-pituitary-thyroid axis disruption, gut and cutaneous microbiome dysbiosis, and compromised antiviral and antifungal immunity, with the latter potentially amplifying vulnerability to Batrachochytrium dendrobatidis and to ranavirus. Among reptiles, sea turtles display near-universal MP ingestion with documented maternal transfer to eggs; freshwater turtles, terrestrial squamates, and crocodilians remain critically understudied. Three structural asymmetries constrain current ecotoxicological risk characterization: taxonomic bias toward anurans and sea turtles, geographic bias toward the Global North, and experimental bias toward acute, supra-environmental laboratory exposures using pristine, single-polymer particles that fail to capture the chemical complexity of weathered field mixtures. We argue that MP burden may warrant consideration as a candidate stressor criterion within IUCN Red List assessments and within environmental risk assessment frameworks for freshwater and terrestrial biodiversity once a robust quantitative relationship between MP burden and demographic decline or population-level fitness has been established, and propose six hypothesis-driven research priorities: methodological standardization, reptile toxicokinetics, transgenerational epigenetics, MP-pathogen microbiome interactions and their translation into population viability models, temperature & times; MP interaction under climate warming, and population-genetic consequences of contemporary MP-driven selection, as the most tractable avenues for ecotoxicological progress and for the development of herpetofauna-specific risk characterization frameworks.
- MakaleAçık Erişim2026Pan-Immune-Inflammation Value as an Independent Indicator of Isolated Coronary Artery Ectasia
Tunca, Cagatay; Özkan, Mehmet Taha; Ergin, Berin Nur; Gök, Saner Bahadir; Tas, Alperen; Kürklü, Haci Ali; Akbuga, Kursat; Tanik, Veysel Ozan; Özlek, Bulent
Objective: Coronary artery ectasia (CAE) is increasingly recognized as an active inflammatory vascular disorder rather than a benign anatomical variant. The pan-immune-inflammation value (PIV) is a novel biomarker integrating neutrophil, monocyte, platelet, and lymphocyte counts, providing a comprehensive measure of systemic inflammation. This study aimed to evaluate the association between PIV and CAE and to compare their diagnostic performance with that of conventional inflammatory indices. Method: In this retrospective case-control study, 17,538 patients who underwent elective coronary angiography between 2018 and 2024 were screened. A total of 228 patients with isolated CAE and 296 age-, sex-, and Body Mass Index (BMI)-matched controls with normal coronary arteries were included. Hematologic and biochemical parameters were analyzed, and inflammatory indices were calculated. Logistic regression and receiver operating characteristic (ROC) analyses were performed to identify independent predictors and assess diagnostic performance. Results: Patients with CAE had significantly higher PIV levels compared to controls (801.6 [504.4-1301.8] vs. 491.8 [302.4-872.7], P < 0.001). In multivariable logistic regression, log-transformed PIV remained independently associated with CAE (odds ratio [OR]: 1.987, 95% confidence interval [CI]: 1.057-3.737, P = 0.033), along with hypertension, triglycerides, high-density lipoprotein (HDL) cholesterol, and serum creatinine. PIV demonstrated the highest discriminative ability among all inflammatory indices (area under the curve [AUC]: 0.674, 95% CI: 0.623-0.722), and correlated strongly with the Systemic Immune-Inflammation Index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and Systemic Inflammation Response Index (SIRI) (P = 0.75-0.94). Conclusion: Elevated PIV levels are independently associated with CAE, reflecting the pivotal role of systemic inflammation in its pathogenesis. Given its simplicity and availability, PIV may serve as a practical adjunctive marker for identifying patients at risk of CAE, warranting validation in larger prospective studies.
- Editöre MektupAçık Erişim2026Reply to the Letter to the Editor: Enhancing Risk Stratification in Coronary Artery Ectasia: The Synergy of Inflammation and Metabolic Scores
Tunca, Cagatay; Özkan, Mehmet Taha; Ergin, Berin Nur; Gök, Saner Bahadir; Tas, Alperen; Kürklü, Haci Ali; Akbuga, Kursat; Tanik, Veysel Ozan; Ars, Kardiyol Dern
- MakaleYalnız künye2026Contralateral DTI-ALPS index as a prognostic biomarker in IDH-wildtype glioblastoma: integrating extent of resection and sex-stratified analyses
Aygün, Tayfun; Keskin, Arif; Palanci, Ozgur; Öztanir, Mustafa Namik; Yücel, Nurullah; Hekimoglu, Gulam
Aim This study aimed to evaluate the independent prognostic value of the contralateral DTI-ALPS index in IDH-wildtype glioblastoma, incorporating tumor morphometry, extent of resection, and sex-stratified analyses within a multivariable framework.Methods A retrospective analysis was performed on 153 IDH-wildtype glioblastoma patients from the publicly available UPENN-GBM dataset. Contralateral DTI-ALPS was calculated using DSI Studio via manual ROI placement; tumor morphometry was derived from expert-annotated segmentation labels using 3D Slicer. Survival analyses included Kaplan-Meier estimation, multivariable Cox regression, time-dependent ROC, restricted cubic spline, and sequential C-index comparison with likelihood-ratio testing.Results The contralateral DTI-ALPS index independently predicted overall survival after adjustment for age, sex, tumor volume, and GTR status (HR = 0.405, 95% CI: 0.227-0.725, p = 0.002). Each one standard deviation increase in DTI-ALPS was associated with a 24.2% reduction in mortality risk. GTR >= 90% (HR = 0.651, p = 0.017) and age (HR = 1.021, p = 0.007) also retained independent significance. DTI-ALPS significantly improved model discrimination beyond age alone (C-index: 0.625 -> 0.653 -> 0.668; likelihood-ratio test p = 0.002). Time-dependent AUC reached 0.741 at 6 months. ALPS-based stratification was more pronounced in the subtotal resection subgroup. Sex-stratified analyses showed numerically stronger associations in females, but formal interaction testing did not confirm effect modification. In an exploratory MGMT subset (n = 57), DTI-ALPS did not retain independent significance after MGMT adjustment.Conclusion The contralateral DTI-ALPS index may provide complementary prognostic information beyond established clinical predictors in IDH-wildtype glioblastoma; however, given the incomplete MGMT methylation data and ongoing methodological debate regarding the biological validity of DTI-ALPS, these findings should be considered exploratory. Prospective validation in cohorts with complete molecular and treatment data is required.
- MakaleAçık Erişim2026Determinants of healthy orthorexia and orthorexia nervosa: the roles of food security, dietary behaviors, and obesogenic environment
Koçak, Tevfik; Arpa Zemzemoglu, Tuba Eda; Türkkan, Tugba; Bülbül, Kenan; Yilmaz, Birsen
Orthorexia has recently gained attention as a two-dimensional construct centered on a shared health orientation. Recent conceptual developments distinguish healthy orthorexia (HeOr), defined as a non-pathological interest in healthy eating, from orthorexia nervosa (OrNe), characterized by rigid and compulsive food control accompanied by psychological and social impairment. This cross-sectional study investigated the associations of HeOr and OrNe with sociodemographic variables, dietary behaviors, and obesogenic environmental factors, and aimed to identify shared and distinct determinants of these tendencies with 1,015 adults aged 18-65 years. Orthorexia tendencies were assessed using the Teruel Orthorexia Scale. Additional measures included the Sustainable and Healthy Eating Behaviors Scale, Short Screening Questionnaire of Highly Processed Food Consumption, Adult Food Security Survey Module, Food Label Reading Attitude Scale, Food Choice Questionnaire, and the Obesogenic Environment Assessment Scale. In the adjusted regression models, HeOr was positively associated with sustainable and healthy eating behaviors (beta = 0.26), AFSS food-insecurity severity score (beta = 0.11), food label reading attitudes (beta = 0.07), health-related food choice motives (beta = 0.09), natural-ingredient preference (beta = 0.14), weight-control motives (beta = 0.15), ethical food choice motives (beta = 0.10), and obesogenic social determinants and effects (beta = 0.09). Conversely, affordability-related motives (beta = -0.08), emotional appeal (beta = -0.15), familiarity (beta = -0.10), and obesogenic cultural determinants/access to experts (beta = -0.12) were negatively associated with HeOr. For OrNe, positive associations were observed with sustainable and healthy eating behaviors (beta = 0.13), AFSS food-insecurity severity score (beta = 0.17), mood-related food choice motives (beta = 0.13), weight-control motives (beta = 0.26), familiarity (beta = 0.09), ethical food choice motives (beta = 0.18), and obesogenic social determinants and effects (beta = 0.30), whereas health-related food choice motives (beta = -0.12), affordability-related motives (beta = -0.08), and emotional appeal (beta = -0.24) showed negative associations. These findings suggest that orthorectic tendencies are associated with individual health motivations as well as broader behavioral and environmental contexts; however, because of the cross-sectional design, these associations should be interpreted as correlational and hypothesis-generating rather than causal.
